SEXTON et al v. RIZZETTA et al
OPINION. Signed by Judge Robert B. Kugler on 12/7/2017. (tf, ) (Main Document 137 replaced on 12/7/2017) (tf, ).
IN THE UNITED STATES DISTRICT COURT
FOR THE DISTRICT OF NEW JERSEY
Allyson SEXTON, general administratix
and administratix ad prosequendum of the
Estate of Brett J. SEXTON, and Allyson
Civil No. 15-3181 (RBK/AMD)
Anthony J. RIZZETTA, D.O., et al.,
This matter comes before the Court upon the motion of Cape Regional Medical Center
(“Defendant”) to limit damages to $250,000 under the New Jersey Charitable Immunity Act, N.J.
Stat. Ann. § 2A:53A-7 et seq. (See Doc. No. 77.) Because Defendant is a charitable organization
that is organized exclusively for hospital purposes, and because Plaintiff was a beneficiary of its
services, Defendant’s motion is GRANTED.
On July 12, 2013, Brett Sexton was admitted to Cape Regional Medical Center. (Def. Ex.
B at 8.) He was diagnosed with a litany of issues, and a nursing triage evaluation in the emergency
department states he was suffering from diffuse pain in the epigastric region radiating to flanks,
shoulder pain, anxiety, panic, and vomiting. (Id.) He began to experience delirium tremens. (Def.
Ex. B at 8.) Defendant’s nursing staff then administered medications such as Ativan and Haldol to
alleviate his combativeness and anxiety. (Id.) Mr. Sexton was also restrained by hospital staff.
Once he was non-combative, hospital staff turned him to a supine position. He was then found
unresponsive; his face was blue and gray; there were no vital signs. Resuscitative efforts were
unsuccessful. Mr. Sexton was pronounced deceased.
The amended death certificate dated September 4, 2013 documented sudden cardiac arrest
during physical struggle while Mr. Sexton was restrained, along with acute necrotizing
pancreatitis, dilated cardiomyopathy, chronic ethanol abuse, and obesity as causes of death. The
autopsy report indicated Mr. Sexton had been subject to serious physical stresses. The death
certificate stated homicide.
Mr. Sexton’s estate, the plaintiff in this matter, then filed an action for medical malpractice,
alleging—among other things—that the hospital deviated from the duty of care resulting in Mr.
Sexton’s death. (Def. Ex. B. at 8-9.) Defendant has filed a motion to limit damages pursuant to the
New Jersey Charitable Immunity Act, claiming to have been a non-profit organization organized
exclusively for hospital purposes since before July 2013. (Def. Ex. A at 1.) It has presented an
affidavit stating as much. We now address that motion.
Under the New Jersey Charitable Immunity Act, the liability of nonprofit hospitals to
negligence actions is limited to $250,000. N.J. Stat. § 2A:53A-8. Close scrutiny of this statutory
scheme will reveal the disposition of this motion. Section 2A:53A-7(a) completely immunizes
entities “organized exclusively for religious, charitable or educational purposes” from negligence
actions brought by “beneficiaries” of those entities’ activities, while § 2A:53A-7(b) immunizes
nonprofit hospitals in particular from any such negligence action. Section 2A:53A-8, however,
provides that “notwithstanding” the blanket immunity of § 2A:53A-7, any nonprofit organized
exclusively for hospital purposes shall be liable in a negligence action for no more than $250,000,
inclusive of interest and costs. Thus, as the Supreme Court of New Jersey has explained,
By the plain language of N.J.S.A. 2A:53A–7 and –8, a hospital is subject to limited
liability under section 8 if it is formed as a nonprofit corporation, society, or
association, is organized exclusively for hospital purposes, was promoting those
objectives and purposes at the time the plaintiff was injured, and the plaintiff was a
beneficiary of the activities of the hospital.
Kuchera v. Jersey Shore Family Health Ctr., 221 N.J. 239, 249, 111 A.3d 84, 90 (2015).
Importantly, the Act’s grant of immunity is to be applied liberally, N.J. Stat. Ann. § 2A:53A-10,
and we are to rely on the text of the statute in interpreting it. See Pizzullo v. New Jersey Mfrs. Ins.
Co., 196 N.J. 251, 264 (2008).
Plaintiff first argues this provision is unconstitutional, but this is without merit. “The
constitutionality of the charitable immunity legislation, which has been part of our statutory law
for more than thirty years, is now well settled.” Johnson v. Mountainside Hosp., 239 N.J. Super.
312, 320, 571 A.2d 318, 322 (App. Div. 1990). When determining state law, this Court predicts
how the state’s courts would apply it; it does not fashion it anew. See Erie Castings Co. v. Grinding
Supply, Inc., 736 F.2d 99, 100 (3d Cir. 1984) (“When the highest state court has not rendered an
authoritative pronouncement, the task of a federal tribunal is to predict how that court would
rule.”). We will therefore not overrule an interpretation by the courts of New Jersey on the validity
of a New Jersey statute under the New Jersey Constitution.
Plaintiff’s primary argument in opposing the motion is that the charitable immunity statute
does not apply to Defendant. The statute applies to a “nonprofit corporation . . . organized
exclusively for hospital purposes,” which shall be liable for no more than $250,000. N.J. Stat. Ann.
§ 2A:53A-8. Plaintiff emphasizes the exclusivity of this language, and draws on Klein v. Bristol
Glen, Inc., 2010 WL 3075582 (App. Div. 2010) for the argument that the hospital must show that
it is actually a nonprofit and not one solely in name. Klein addresses whether a nursing home
raking in millions of dollars can be considered a “charitable” entity under § 2A:53A-7(a). The
court noted the searching inquiry given to entities describing themselves as “charitable” and the
risk that profit-seeking enterprises would seek to immunize themselves in contravention of public
policy and common decency. Entities whose operations were “virtually exclusively funded by
government money and compensation paid by the private market for value received” were not
entitled to charitable immunity. Klein, 2010 WL 3075582, at *6 (quotations omitted). Plaintiff asks
that this Court extend Klein’s searching inquiry of whether an entity is indeed “charitable” under
§ 2A:53A-7(a) to whether, under § 2A:53A-8, an entity is actually a “nonprofit.” Plaintiff contends
the policy of treating all hospitals as nonprofits, “except obviously for tax purposes,” (Pl. Br. at 8),
is a bad one for purposes of immunity.
Article III courts do not generally make policy decisions, and that is especially the case
when a federal court, sitting in diversity, is asked to predict how the courts of New Jersey would
apply their own laws. But today we do not need to make those decisions, for Klein does not stand
for the proposition Plaintiff argues it does. Rather, Klein took a close look at whether an entity is
indeed engaged in “charitable purposes” under § 2A:53A-7(a). That term’s analog in § 2A:53A-8
is “hospital purposes,” and there is no reason—and none has been presented—to doubt that
Defendant is indeed engaged in the operation of a hospital. Although Plaintiff would have this
Court apply the searching inquiry of Klein to the term “nonprofit,” Klein itself did not scrutinize
the non-profit status of the nursing home before it. And that is because “[n]onprofit status cannot
be equated with charitableness.” Hamel v. State, 321 N.J. Super. 67, 74 (App. Div. 1999). We will
not conflate the terms. If New Jersey courts find tax status suffices to show nonprofit status for
purposes of the Charitable Immunity Act, so will this Court. See Parker v. St. Stephen's Urban
Dev. Corp., 243 N.J. Super. 317, 324 (App. Div. 1990) (noting that an entity seeking charitable
immunity is a nonprofit under § 501(c)(3) of the Internal Revenue Code). And we will likewise
rely on what other courts have found sufficient.
Defendant has produced an affidavit showing it is a nonprofit organization organized
exclusively for hospital purposes. (Def. Ex. A.) It states that Cape Regional Medical Center has
been continuously organized as a non-profit exclusively for hospital purposes since before July
2013. (Id.). Plaintiff has not seriously contested this document’s validity, and we find it sufficient.
See Mottola v. Union City, 2006 U.S. Dist. LEXIS 52258 at *5 (D.N.J. July 31, 2006) (finding that
defendants satisfied the Charitable Immunity Act by producing two affidavits from hospital staff
demonstrating the hospital was a nonprofit entity organized exclusively for hospital purposes); see
also Hottenstein, 981 F. Supp. 2d at 294 (finding that defendants satisfied the Act by producing
certification from hospital staff stating that it was a nonprofit entity organized exclusively for
hospital purposes and a Revised Articles of Incorporation which supported that assertion).
The Court also finds that Mr. Sexton was a beneficiary of Defendant’s services, as is
necessary for the Act to apply, under the liberal view mandated by § 2A:53A-10. He was admitted
to Cape Regional Medical Center, where he received triage evaluation, multiple medications, and
other nursing assessments. (Def. Ex. B at 8.); see Mottola, 2006 U.S. Dist. LEXIS 52258 at *6
(stating that “every patient at the hospital receiving care is a beneficiary of its work.”). The triage
evaluation, medications, and other nursing assessments all compel the conclusion that Mr. Sexton
was a beneficiary of Defendant’s services. See Hottenstein, 981 F. Supp. 2d at 294 (stating that the
court decided to follow the Legislature’s instructions to “liberally construe the definition of
beneficiary so as to afford immunity to qualifying entities ‘in furtherance of public policy for the
protection of [such entities].’”) (citations omitted).
We therefore find that Defendant falls within the scope of the limited liability granted by
For the foregoing reasons, Defendant’s Motion to Limit Damages will be granted. An
/s Robert B. Kugler
ROBERT B. KUGLER
United States District Judge
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